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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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Principios rectores para la intervención coronaria percutánea de oclusión total crónica
Emmanouil S Brilakis1, Kambis Mashayekhi2, Etsuo Tsuchikane3
1Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, MN (E.S.B., M.N.B.).
Circulation
|July 30, 2019
Resumen
Siete mejores prácticas para la oclusión total crónica (OTC) y la intervención coronaria percutánea (ICP) mejoran los resultados. La adopción de estos principios, incluidas las técnicas avanzadas y la experiencia del operador, es crucial para el éxito de la CTO-PCI y mejores resultados para los pacientes.
Área de la Ciencia:
- Cardiología
- Cardiología intervencionista
Sus antecedentes:
- Los resultados para la oclusión total crónica (OTC) de la intervención coronaria percutánea (ICP) han mejorado significativamente debido a los avances en los equipos y técnicas.
- La colaboración mundial ha permitido identificar las mejores prácticas ampliamente aceptadas para la CTO-PCI.
Objetivo del estudio:
- Esbozar 7 principios comunes que representan las mejores prácticas para el CTO-PCI.
- Subrayar la importancia de estos principios para lograr altas tasas de éxito y gestionar las complicaciones.
Principales métodos:
- Identificación y síntesis de 7 principios rectores para el CTO-PCI a través de la colaboración global y el intercambio de conocimientos.
- Revisión de las técnicas establecidas, incluida la angiografía coronaria dual, el uso de microcatéteres, los enfoques antegrado y retrógrado y la preparación de la lesión.
Principales resultados:
- Los 7 principios cubren las indicaciones, la planificación, la manipulación del alambre guía, las estrategias de cruce, la adaptación de la técnica, la experiencia del operador y la colocación de stents.
- Los operadores experimentados y los centros que se adhieren a estos principios logran un alto éxito y tasas de complicaciones aceptables.
Conclusiones:
- La adopción generalizada de estos 7 principios es esencial para mejorar los resultados de la CTO-PCI.
- Se necesitan más investigaciones, educación y capacitación para desarrollar estrategias de cruce y revascularización de CTO más simples y seguras y mejorar la adopción por parte de los centros con menos experiencia.
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